Community Youth Scholarship Fund
Funded by tax dollars from the City of Manhattan and Private Donations
Scholarship Application Form
Child=s Name:
Birth Date:
Parent Name:
Grade:
Home Phone:
Address:
Office Phone:
City/State/Zip:
Email:
Are you a military dependent? G Yes G No
Are you submitting a scholarship application for anyone else in your family? G Yes G No
If Yes, name of child or children:
Program you wish to participate in:
Start Date:
Total Registration Fee: $
Scholarships are awarded on the basis of financial need. Please explain why you are applying for a scholarship.
Print clearly.
Family/Household Size:
Total Annual Family Income: $
Parent/Guardian Signature:
Date:
NOTE: UFM is the administrative agent for the scholarship. The information you provide on this application
form is kept strictly confidential by UFM.
Return application to: UFM, 1221 Thurston Street, Manhattan, KS 66502
Questions? Call 785-539-8763
Date Received:
Reason:
Parent Notified:
Voucher Issued Date:
Computer Entry:
For Office Use Only
Scholarship Awarded: G Yes G No
Amount Awarded: $
Voucher Returned Date:
Rev. 09-04-2012
Community Youth Scholarship Fund
Guidelines for Distribution
Money has been made available through tax dollars from the City of Manhattan for use as scholarships for
youth activities in Manhattan. Scholarships may be requested for any Manhattan program. UFM Community
Learning Center is the administrative and distribution agent. Applications will be received at UFM. In order to
provide as much assistance as possible, the following guidelines have been established.
1. Scholarships are available to help pay the partial costs of attending any youth program activity in Manhattan.
Scholarships are available anytime during the year as long as funds are available.
2. Youth in grades Preschool-12th grade and residing in Manhattan are eligible for scholarships.
3. Scholarships are available to pay up to 50% of program activity fee or a maximum of $100 per person or
$300 per family. This amount cannot be guaranteed. Total requests will determine the amount of individual
scholarship awards that are possible.
4. One application will be accepted per child per semester. Scholarships will be awarded for only one class,
activity or program session per child. For example, one UFM class, one session of day camp, one session of
swim lessons.
5. Families should check with their desired program agency to be sure there are no scholarships available from
that agency before applying to the Community Youth Scholarship Fund.
6. Income guidelines up to 185% of the poverty guideline generally apply, but may be reduced depending on
amount of funding and total amount of scholarship requests.
7. Maximum age limit: Age 18 or High School Senior
8. Spring scholarships are awarded on an as-requested basis. Due to the high volume of requests for summer
scholarships, summer scholarship applications are held until a set deadline and awards are made all at once. Fall
scholarships may be available if funds remain.
9. Awards will be made on timeliness of application and family need until funds are exhausted. Scholarship
awards may be adjusted to provide assistance to as many children as possible.
10. Scholarship applications will be submitted to UFM Community Learning Center, 1221 Thurston,
Manhattan, KS 66502. For questions, call 539-8763.
11. Awards will be made in the form of vouchers to present to the program in which the child is enrolling. The
program will return the voucher to UFM for payment. No cash awards are made except by prior approval as
reimbursement for enrollment. A receipt for the paid enrollment fee is required for reimbursement.
12. Awards will be made as soon as possible after applications are received or following set deadlines.
Rev. 09-04-2012